Orthopedic external fixation device

ABSTRACT

An orthopedic system includes a universal joint. The universal joint includes a ball from which a stem extends, a housing, and a connecting piece. The housing includes a first portion and a second portion that together define a spherical internal volume that is sized and configured to receive the ball therein. The first portion defines a first opening through which at least one of a portion of the ball or a portion of the stem extends, and the second portion defining a second opening therethrough. The connecting piece includes a first threaded stem portion, a second threaded stem portion, and a middle portion disposed between the first and second threaded stem portions. The first threaded stem portion is sized and configured to be received within the second opening defined by the second portion and to contact the ball to generate a frictional interference to lock the universal joint.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a division of U.S. patent application Ser. No.13,896,060, filed May 16, 2013, which is a continuation of U.S. patentapplication Ser. No. 13,568,302, filed Aug. 7, 2012 (now U.S. Pat. No.8,454,604), which is a continuation of U.S. patent application Ser. No.12/711,591, which was filed Feb. 24, 2010 (now U.S. Pat. No. 8,257,353),the entireties of which are herein incorporated by reference.

FIELD OF THE INVENTION

The present disclosure relates to the field of orthopedic devices andmore particularly to an external fixation device for providing fixationor immobilization of fractured bone is facilitated by means external tothe body soft tissue.

BACKGROUND

Orthopedic external fixation devices are used in many orthopedictreatments to fixate, distract, compress, or reduce bone segments and tocorrect deformities. Generally, fixation devices or fixators are used tostabilize fractured bone pieces and to facilitate the healing of bonesat a bone repair site. Such fixators can be used by orthopedic surgeonsto restore the patient's anatomy at a fracture following an injury ordistract an osteotomy site in bone lengthening or shortening procedures.One type of external fixation devices comprise two base membersconnected by one or more of adjustable struts that can be adjusted toset the two base members into a desired relative configuration that isappropriate for treating a particular orthopedic fracture, nonunion,malunion, or deformities of skeletal bone fragments. The base membersusually have ring-like structures and can be full rings or partialrings. In one conventional example disclosed in U. S. Pat. No. 6,030,386to Taylor et al., adjustable telescoping struts connect two ring-likestructures via conventional universal-universal-joints that provide avariety of attachment angles. However, the conventional universal jointsdo not provide the ability to lock the attachment angle whileconfiguring the external fixation device.

Therefore, there is a continuing need for an improved external fixatorand adjustable struts that is simpler to use while maintaining therobust adjustability to be able to configure the external fixators for avariety of orthopedic fixation applications.

SUMMARY

According to an embodiment of the present disclosure, a lockinguniversal joint hinge is disclosed. The locking universal joint hingehas a first and a second orthogonally oriented pivot axes and theuniversal joint hinge comprises a first-axis clevis connector having afirst arm and a second arm and a second-axis clevis connector having afirst arm and a second arm. A cross-shaft member is positioned betweenthe two arms of each clevis connectors. A first-axis clevis pinpivotally connects the two arms of the first-axis clevis connector tothe cross-shaft member and defines the first pivot axis. A second-axisclevis pin pivotally connects the two arms of the second-axis clevisconnector to the cross-shaft member and defines the second pivot axis.The first-axis clevis pin extends from the first arm to the second armof the first-axis clevis connector and through the cross-shaft member,wherein the first-axis clevis pin is configured and adapted to lock thefirst pivot axis by urging the cross-shaft member against one of the twoarms of the first-axis clevis connector, thereby, causing a surface ofthe cross-shaft member to contact a surface of the one of the two armsof the first-axis clevis connector and generate a frictional ormechanical interference between the two contacting surfaces.

According to an embodiment of the present disclosure, a telescopicallyadjustable strut for use with orthopedic external fixators has a firstend and a second end and includes a universal joint connector providedat each of the first and second ends for connecting the strut toorthopedic external fixator base members. The universal joint connectoris configured and adapted for pivoting the strut relative to the basemembers and to lock the universal joint connector at a desired angle.

The strut comprises an elongated shaft with a hollow axial center; alead screw having external threads, one end of the lead screw extendinginto the axial center of the shaft; and an adjustment knob rotatablyattached to one end of the elongated shaft and provided with anaxially-oriented opening through which the lead screw extends. A secondend of the elongated shaft opposite the adjustment knob defines thefirst end of the strut and a second end of the lead screw opposite theend extending into the adjustment knob defines the second end of thestrut.

The adjustment knob is provided with a release button that is movablebetween an engaged position and a released position. The release buttonis configured to threadably engage the external threads of the leadscrew when in the engaged position and disengage from the externalthreads of the lead screw when in the released position. The adjustmentknob and the release button are provided with a ball detent arrangementfor holding the release button in the released position as the defaultposition. The lead screw and the shaft are configured to prevent axialrotation of the lead screw relative to the shaft, whereby rotation ofthe adjustment knob when the release button is in the engaged positioncauses the lead screw to linearly translate along the longitudinal axisof the shaft.

In another embodiment, the release button is configured to be held inthe engaged position as the default position. The release button can bespring-biased to hold the release button in the engaged position untilmoved into the released position.

According to another embodiment of the present disclosure, an orthopedicexternal fixator is disclosed. The orthopedic external fixator includesa pair of ring-like base members that are connected by a plurality ofthe telescopically adjustable struts. The pair of ring-like base memberscan be connected by one or more of the telescopically adjustable strutsin combination with one or more of other types of adjustable struts oradjustable hinges.

The ability to quickly release the lead screw button when adjusting thelengths of the adjustable strut makes adjusting the external fixatorutilizing the adjustable strut of the present disclosure substantiallymore efficient than those external fixation systems utilizingconventional struts.

According to another embodiment, additional base members can be added tothe orthopedic external fixator beyond the first pair mentioned aboveand connected to the assembly formed by the first pair by additionalplurality of the telescopically adjustable struts.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is perspective view of a preferred embodiment of an orthopedicexternal fixator of the present disclosure.

FIG. 2 is a perspective view of another embodiment of an orthopedicexternal fixator of the present disclosure.

FIG. 3A is an isometric view of one of the single-hinged struts shown inFIG. 2 with one of the threaded rods removed from the locking universaljoint hinge.

FIG. 3B is a plan view of the single-hinged strut of FIG. 3A.

FIG. 3C is a longitudinal section view of the single-hinged strut ofFIG. 3B the section being taken through the line A-A in FIG. 3B.

FIG. 4A is an isometric view of a universal joint shown in FIG. 3A froma different angle.

FIG. 4B is a plan view of the universal joint of FIG. 4A looking downinto the X-axis.

FIG. 4C is a cross-sectional view of the universal joint of FIG. 4Awherein the section is taken through the plane A-A shown in FIG. 4B.

FIG. 4D is a cross-sectional view of the universal joint of FIG. 4Awherein the section is taken through the plane B-B shown in FIG. 4B.

FIG. 5 is a plan view of a preferred embodiment of the adjustable strutof the external fixator of FIGS. 1 and 2 in its retracted configuration.

FIG. 6A is an isometric view of the adjustable strut of FIG. 5 in itsretracted configuration.

FIG. 6B is an isometric view of the adjustable strut of FIG. 5 in itsextended configuration.

FIGS. 7 and 8 are additional plan views of the adjustable strut of FIG.5.

FIG. 9A is a longitudinal cross-sectional view of one embodiment of theadjustable strut of the present disclosure with the adjustment knob inthe released position.

FIG. 9B is a transverse cross-sectional view through the adjustment knobshown in FIG. 9A in the released position.

FIG. 9C is a longitudinal cross-sectional view of the adjustable strutshown in FIG. 9A with the adjustment knob in the engaged position.

FIG. 9D is a transverse cross-sectional view through the adjustment knobshown in FIG. 9C in the engaged position.

FIG. 10A is a longitudinal cross-sectional view of another embodiment ofthe adjustable strut of the present disclosure with the adjustment knobin the engaged position.

FIG. 10B is a transverse cross-sectional view through the adjustmentknob shown in FIG. 10A in the engaged position.

FIG. 10C is a longitudinal cross-sectional view of the adjustable strutshown in FIG. 10A with the adjustment knob in the released position.

FIG. 10D is a transverse cross-sectional view through the adjustmentknob shown in FIG. 10C in the released position.

FIG. 11A is an isometric view of a ball-joint embodiment of theuniversal-hinged connector of the adjustable strut of the presentdisclosure.

FIG. 11B is a longitudinal cross-sectional view of the ball-jointembodiment of FIG. 11A.

FIG. 11C is a cross-sectional view of another example of a ball-joint inaccordance with some embodiments.

FIG. 11 D is a cross-sectional view of one example of a locking pin ofthe ball-joint illustrated in FIG. 11C in accordance with someembodiments.

The features shown in the above referenced drawings are illustratedschematically and are not intended to be drawn to scale nor are theyintended to be shown in precise positional relationship. Like referencenumbers indicate like elements.

DETAILED DESCRIPTION

In the following detailed description of the preferred embodiments,reference is made to the accompanying drawings which form a part hereof,and in which are shown by way of illustration specific embodiments inwhich the invention may be practiced. Other embodiments may be utilizedand structural changes may be made without departing from the scope ofthe present invention.

Referring to FIG. 1, an orthopedic external fixator 20 according to apreferred embodiment will be described. The orthopedic external fixator20 generally includes a pair of base members 21, 22 that have ring-likestructures that are connected by a plurality of telescopicallyadjustable struts 100. Each of the ring-like base members 21, 22 can bea fully encircling ring as shown or a partial ring, such as a generallyU-shaped foot ring.

In the illustrated example, the two base members 21, 22 are connected bysix telescopically adjustable struts 100. The telescopically adjustablestruts 100 enable the orthopedic surgeon to configure and adjust theorientation of the two base members 21, 22 relative to each other byadjusting the lengths of each strut 100. Such feature of the externalfixator 20 is useful for treating a variety of fractures, nonunions,deformities and malunions of skeletal bone fragments.

The actual number of telescopically adjustable struts 100 used incombination with the base members 21, 22 can be different depending uponthe needs of the particular application. This is especially true wheredifferent types of adjustable struts or hinges are utilized inconjunction with the adjustable struts 100 in configuring the externalfixator 20. FIG. 2 illustrates an example of such orthopedic externalfixator 20A, in which two ring-like base members 21, 22 are connected byone telescopically adjustable strut 100 and two single-hinged struts200.

The single-hinged struts 200 include two threaded rods 212, 214 joinedby a locking universal joint hinge 240. The axes of the lockinguniversal joint hinges 240 are configured to lock the universal jointhinges 240 at a desired angle. The two threaded threaded rods 212, 214connect to the universal joint hinge 240 by threading into the universaljoint hinge 240 from opposite ends. As shown in FIG. 2, the universaljoint hinges 240 can be configured to receive a wire 202 therethrough sothat in the assembled arrangement 20A, the wire 202 can be extendedthrough the universal joint hinges 240 of two oppositely positionedsingle-hinged struts 200 for aligning the single-hinged struts 200.

Referring to FIGS. 3A-3C and 4A-4D, the structure of the lockinguniversal joint hinge 240 will be described in more detail. FIG. 3Ashows the locking universal joint hinge 240 with one of the two threadedrods 212 threaded into the universal joint hinge 240 while the otherthreaded rod 214 has been removed for illustration purposes.

The isometric views of the universal joint hinge 240 in FIGS. 3A and 4Ashow two pivot axes X and Y associated with the universal joint hinge240. The locking universal joint hinge 240 comprises two clevisconnectors, an X-axis clevis 241 and a Y-axis clevis 242 that arepivotally connected by a cross-shaft member 250. An X-axis clevis pin231 pivotally connects the X-axis clevis 241 to the cross shaft member250 and allows the X-axis clevis 241 to pivot about the first pivot axisX. A Y-axis clevis pin 232 pivotally connects the Y-axis clevis 242 tothe cross shaft member 250 and allows the Y-axis clevis 242 to pivotabout the second pivot axis Y. It should be noted that in theillustrated embodiment, the cross-shaft member 250 is configured to havethe X and Y pivot axes intersect orthogonally. Therefore, while theX-axis clevis pin 231 is a single piece pin extending through thecross-shaft member 250 as shown in the cross-sectional views of FIG. 3Cand 4C, the Y-axis clevis pin 232 comprises two pieces pivotallyconnecting the Y-axis clevis 242 to the cross-shaft member 250 as shownin FIG. 4D. To allow for the wire 202 described above, the X-axis clevispin 231 is provided with a cannula 231 c extending longitudinallytherethrough as shown in FIGS. 3C and 4C.

Each of the X-axis clevis 241 and the Y-axis clevis 242 are providedwith threaded holes 241 h, 242 h, respectively, for receiving thethreaded rods 212, 214. The threaded holes 241 h, 242 h are oriented sothat their threading axes are orthogonal to their respective X and Ypivot axes. In other words, the longitudinal axis of the threaded hole241 h is orthogonal to the pivot axis X and the longitudinal axis of thethreaded hole 242 h is orthogonal to the pivot axis Y. Thus, when thetwo clevis connectors 241, 242 are positioned as shown in FIGS. 3A and4A with the threaded holes 241 h, 242 h at opposite ends of theuniversal joint hinge 240, the threaded rods 212, 214 threaded into theinternally threaded holes 241 h, 242 h will be axially aligned along theaxis Z.

Referring to FIGS. 3C and 4C, the X-axis clevis pin 231 is structuredlike a bolt and has a head and a shaft. The head of the X-axis clevispin 231 will be referred to herein as the proximal end of the pin andthe opposite end of the shaft will be referred to as the distal end ofthe pin. The X-axis clevis 241 has a generally U-shaped structure andhas two arms 241 a, 241 b with the cross-shaft member 250 positioned inbetween the two arms. The shaft of the X-axis clevis pin 231 extendsfrom the first arm 241 a, through the cross shaft member 250, to thesecond arm 241 b through holes provided in the arms 241 a, 241 b. Thedistal end of the X-axis clevis pin 231 threadably engages the arm 241 aand is held in place. In order to prevent unintentional removal of theX-axis clevis pin 231, the distal end of the pin can be mechanicallysecured. In the example shown, a snap ring 235 is used to keep theX-axis clevis pin 231 from being removed. In another example, a cotterpin or other suitable mechanical means can be used in place of the snapring 235.

According to a preferred embodiment, the universal joint hinge 240 isconfigured for locking the X and Y pivoting axes of the X-axis clevis241 and the Y-axis clevis 242. The X axis can be locked by tighteningthe X-axis clevis pin 231. The shaft of the X-axis clevis pin 231 has alarger diameter than the rest of the shaft and a shoulder 231 acircumscribing the shaft of the pin is defined where the diameterchanges. The shoulder 231 a of the X-axis clevis pin 231 has a largerdiameter than the opening in the cross-shaft member 250 through whichthe X-axis clevis pin 231 extends. Therefore, when the X-axis clevis pin231 is threaded further toward its distal end by tightening the clevispin 231, the shoulder 231 a urges the cross-shaft member 250 against theX-axis hinge arm 241 a (see FIGS. 4C and 4D). The inner surface 245 ofthe X-axis clevis arm 241 a that contacts the cross-shaft member 250 andthe corresponding contacting surface 255 of the cross-shaft member 250are configured to frictionally or mechanically engage each other andlock the X-axis clevis 241 and the cross-shaft member 250 together. Thislocking prevents the X-axis clevis 241 from pivoting about the X axisrelative to the cross-shaft member 250 and the Y-axis clevis 242. Theinner surface 245 and the contacting surface 255 of the cross-shaftmember 250 can be roughened surfaces, e.g., diamond teethed, knurled,etc. to generate the frictional or mechanical interference and aid inthe locking This locking configuration for the X-axis clevis 241 and theX-axis clevis pin 231 allows the X-axis clevis 241 to be locked at avariety of pivot angles with respect to the Y-axis clevis 242.

The Y axis can be locked by threading the threaded rod 214 into theY-axis clevis 242 until the threaded rod 214 contacts the cross-shaftmember 250 and tightening the threaded rod 214 against the cross-shaftmember 250. By tightening the threaded rod 214 with sufficient forceagainst the cross-shaft member 250, a sufficient frictional interferencebetween the threaded rod 214 and the surface of the cross-shaft member250 can be created to lock and prevent the Y-axis clevis 242 frompivoting about the Y axis. The cross-shaft member 250 has asubstantially spherical shape whose center is located at the point ofintersection of the pivot axis X and the pivot axis Y. The sphericalshape allows the Y-axis clevis 242 to pivot about the pivot axis Y evenwith the threaded rod 214 extending through the clevis up to thecross-shaft member 250 but not quite in locking position.

To further enhance the frictional interference between the threaded rod214 and the surface of the cross-shaft member 250, the respectivecontacting surfaces can be configured and adapted to increase thefrictional force. For example, the outer surface of the cross-shaftmember 250 can be provided with a desired surface roughness. Thecorresponding surface at the end of the threaded rod 214 that contactsthe cross-shaft member 250 can also be configured appropriately toenhance the frictional interference between the two contacting surfaces.For example, the contacting surface of the threaded rod 214 also can beprovided with a desired surface roughness. The contacting surface of thethreaded rod 214 also can be provided with a concave contour matchingthe surface contour of the cross-shaft member 250 to increase thecontact area between the threaded rod 214 and the cross-shaft member250.

According to another embodiment, the cross-shaft member 250 isconfigured to enable locking of the Y-axis clevis 242 only at a singlepredefined angle with respect to the X axis. In the example shown inFIGS. 3A, 3C, 4A and 4C, a band of flat surface 252 is provided on thesurface of the cross-shaft member 250 at least partially circumscribingthe cross-shaft member 250 on the side facing the threaded rod 214advancing through the Y-axis clevis. The band of flat surface 252 isoriented so that it extends parallel to the Y axis and orthogonal to theX axis. In other words, the band of flat surface 252 is positioned atthe equatorial position on the cross-shaft member 250 if the X axis wasviewed as going through the North and South poles of a globe representedby the spherical cross-shaft member 250. The equatorially positionedband of flat surface 252 allows the Y-axis clevis 242 to be locked onlyat a position orthogonal to the X-axis as shown. The threaded rod 214threaded into the internally threaded hole 242 h of the Y-axis clevis242 would be oriented orthogonal to the X-axis. In an alternativeembodiment, the band of flat surface 252 can be oriented at an anglethat is not orthogonal with respect to the X axis in order to allow theY-axis clevis 242 to lock only at that particular angle.

Referring to FIGS. 5-10B, the structure of the telescopically adjustablestrut 100 will be described in more detail. The adjustable strut 100 hasa generally elongated structure comprising two ends. Provided at eachend is a universal joint connector 140A, 140B for connecting theadjustable strut 100 to orthopedic external fixator base members 21, 22.The adjustable strut 100 comprises an elongated shaft 102 with a hollowaxial center 102 c (shown in FIG. 7) and a lead screw 110, one end ofwhich extends into the hollow axial center 102 c.

Provided at one end of the elongated shaft 102 is the universal jointconnector 140A. The universal joint connector 140A connects theelongated shaft 102 end of the adjustable strut 100 to a base member 21,22 of the external fixator 20 while allowing the connection to be madeat a variety of angles and directions. Provided at opposite ends of thestrut 100 is a second universal joint connector 140B that is connectedto the end of the lead screw 110. The universal joint connector 140Bconnects connects the lead screw 110 end of the adjustable strut 100 toanother base member 21, 22 of the external fixator 20 while allowingthat connection to be made at a variety of angles and directions. Theterm “universal-joint connector” as used herein refers to a connectorconnecting two parts that is configured and adapted to bend or flex in avariety of angles.

The universal-joint connectors 140A, 140B can be any type of jointed orhinged connectors that provide robust articulation of the connectionbetween the adjustable strut 100 and the base members 21, 22 of theexternal fixator 20. The robust articulation allows a variety of angularconfigurations for the two ends of the adjustable strut 100 attached tothe base members 21, 22 of the external fixator 20.

Referring to FIGS. 7-9A, the structures of the universal-jointconnectors 140A and 140B will be described in more detail. In theexample of the strut 100 shown, the universal-joint connectors 140A,140B have similar structure as the universal-joint hinges 240 shown inFIGS. 4A-4D. FIGS. 7 and 8 show the two pivot axes X and Y associatedwith the structure of the universal-joint connectors 140A, 140B. Similarto the universal-joint hinge 240, each of the universal-joint connectors140A, 140B comprises two clevis connectors, an X-axis clevis 141 and aY-axis clevis 142 that are pivotally connected by a cross-shaft member150. The arrangement and interacting movement of the X-axis clevis 141and the Y-axis clevis 142 is same as that of the corresponding clevisesin the universal-joint hinge 240. The X-axis clevis 141 connects theuniversal-joint connectors 140A, 140B to the shaft 102 or the lead screw110. The Y-axis clevis 142 connects the universal-joint connectors 140A,140B to the base members 21, 22 by Z-axis screws 160. The Z-axis screw160 is inserted through one of the mounting holes 21 h, 22 h in the basemembers 21, 22 and threaded into the Y-axis clevis 142. An X-axis pin131 and the Y-axis pin 132 correspond to the X-axis pin 231 and theY-axis pin 232, respectively, of the universal-joint hinge 240.

Depending upon which end of the adjustable strut 100 is beingconsidered, the X-axis clevis 141 is configured to be attached to eitherthe shaft 102 or the lead screw 110 at its base portion. A variety ofattachment methods and configurations can be used to attach the X-axisclevis 141 to the shaft 102 or the lead screw 110. In the illustratedexample shown, the attachment between the X-axis clevis 141 and theshaft 102 and/or the lead screw 110 are enabled by a cross pin 180. Thisis better shown in detail in the longitudinal cross-sectional view ofthe adjustable strut 100 shown in FIG. 10A.

Referring to FIG. 9A, in one preferred embodiment, the X-axis clevis 141and the cross-shaft member 150 are configured to enable locking of theX-axis to prevent the X-axis hinge 141 from pivoting about the pivotaxis X. Except for the fact that the X-axis clevis pin 131 is notcannulated, the X-axis clevis pin 131 has the same structure as theX-axis clevis pin 231 of the universal joint hinge 240. The X-axisclevis 141 has a generally U-shaped structure and has two arms 141 a,141 b with the cross-shaft member 150 positioned therebetween. The shaftof the X-axis clevis pin 131 extends from the first arm 141 a, throughthe cross-shaft member 150, and to the second arm 141 b through theopenings provided in the arms 141 a, 141 b. The distal end of the X-axisclevis pin 131 threadably engages the arm 141 a and is held in place. Inorder to prevent unintentional removal of the X-axis clevis pin 131, thedistal end of the pin can be mechanically secured. In the example shown,a snap ring 135 is used to keep the X-asis clevis pin 131 from beingremoved. In another example, a cotter pin can be used in place of thesnap ring 135.

According to a preferred embodiment, the universal joint connectors140A, 140B are configured for locking the X and Y pivoting axes. Thislocking is accomplished in a similar manner to the universal joint hinge240 by the operation of the X-axis clevis pin 131. The X-axis clevis pin131 is configured to have a shoulder, like the shoulder 231 a of theX-axis clevis pin 231, that urges the cross-shaft member 150 toward theX-axis clevis arm 141 a (in the upward direction in FIG. 9A). Thesurfaces of the X-axis clevis arm 141 a and the cross-shaft member 150that contact each other are configured like the corresponding roughenedcontacting surfaces 245 and 255 of the universal joint hinge 240 tofrictionally engage each other for locking the X-axis clevis 141 and thecross-shaft member 150 together.

The Y-axis clevis 142 can be configured to be locked for stopping thepivoting movement of the Y-axis clevis 142 about the pivot axis Y. TheZ-axis screw 160 has an internally threaded longitudinal bore 167 and aY-axis locking screw 170 is threaded into the longitudinal bore 167. Asshown in FIG. 9A, the distal end 175 of the locking screw's stem extendsout of the distal end of the Z-axis screw 160. As shown in FIG. 10A, asthe locking screw 170 is threaded further into the Z-axis screw 160, thedistal end 175 of the Y-axis locking screw 170 extends out of the Z-axisscrew 160 until it contacts the cross-shaft member 150. Tightening theY-axis locking screw 170 against the cross-shaft member 150 generatessufficient frictional interference between the distal end 175 of theY-axis locking screw 170 and the cross-shaft member 150 and lock theY-Y-axis hinge 142 in unison with the cross shaft member 150. Thisprevents any pivoting movement about the Y axis. As shown in FIGS. 9Aand 10A, preferably, the terminal surface of the distal end 175 of theY-axis locking screw 170 that contacts the cross-shaft member 150 has aconcave contour so that the contacting surface area is a circle ratherthan a single point, thus, optimizing the frictional interferencebetween the distal end 175 of the Y-axis locking screw 170 and thecross-shaft member 150.

As mentioned above, the base portion of the Y-axis clevis 142 isconfigured to be attached to a base member 21, 22 of the externalfixator 20 by a Z-axis screw 160. The Z-axis screw 160 is threaded intothe base portion of the Y-axis clevis 142 and has a cylindricalmid-section 165 that is smaller in diameter than the head portion 161 ofthe Z-axis screw 160. The mid-section 165 defines a gap between the headportion 161 of the Z-axis screw 160 and the Y-axis clevis 142 whichaccommodates the thickness of the base member 21, 22 of the externalfixator 20. The Z-axis screw 160 is inserted through one of the mountingholes 21 h, 22 h in the base members 21, 22 and threaded into the baseportion of the Y-axis clevis 142 to secure the strut 100 to the basemember 21, 22. This is better illustrated in FIG. 1. The gap between thehead portion 161 of the Z-axis screw 160 and the Y-axis clevis 142 isappropriately matched to the thickness of the base member 21, 22 suchthat when the strut 100 is attached to the base member 21, 22 and theZ-axis screw 160 is tightened, the base member 21, 22 gets lockedbetween the Y-axis clevis 142 and the head portion 161 of the Z-axisscrew 160 and the strut 100 is prevented from rotating about the Z-axis.

According to another embodiment, the universal-hinged connectors 140A,140B can be implemented using other types of universally flexible jointsother than the universal joint examples described above. FIGS. 11A-11Billustrate an example of an alternate type of connectors. FIGS. 11A-11Bshow a ball-joint 300 example. The ball-ball-joint 300 comprises a ball302 that is captured between two ball-joint housing halves 312, 314. Thefirst ball-joint housing half 312 threads onto the second ball-jointhousing half 314. The internal structures of the two ball-joint housinghalves 312, 314 are configured to form a spherical volume within whichthe ball 302 sits as shown in the cross-sectional view of FIG. 11B. Theball 302 has a stem 303 that extends out of an axially oriented openingin the first ball-joint housing half 312. The stem 303 has a terminalend 304 that is configured and adapted to receive and connect to eitherthe lead screw 110 or the shaft 102 of the adjustable strut 100. In theexample shown in FIGS. 11A, 11B, the terminal end 304 of the stem 303 isprovided with an axially positioned hollow opening 305 for receivingeither the lead screw 110 or the shaft 102. Similar to the adjustablestrut example shown in FIGS. 1 and 5, a cross pin 180 can be utilized tokeep the lead screw 110 or the shaft 102 attached to the terminal end304 of the stem 303.

Threadably attached to the second ball-joint housing half 314 is aconnecting piece 320 for attaching the ball-joint 300 to one of the basemembers 21, 22 of the external fixator 20. The connecting piece 320 hastwo threaded stem portions 322 and 324 extending in opposite directions.The first end 322 is threaded into the second ball-joint housing half314 and the second end 324 is configured for attaching to one of thebase members 21, 22. The connecting piece 320 has a middle portion 325that is configured to accommodate turning by hand or a tool such as awrench. In the illustrated example, the middle portion 325 has asix-sided nut like structure optimized for turning with an open-endedwrench. The second end 324 is threaded to receive a locking nut 330 330for holding the base member 21, 22 between the middle portion 325 andthe locking nut 330. When attaching the ball-joint 300 to one of thebase members 21, 22, the second second end 324 is inserted into one ofthe mounting holes 21 h, 22 h provided on the base members 21, 22 andheld in place by threading the locking nut 330 on to the second end 324.The ball 302 swivels between the two ball-joint housing halves 312, 314to allow adjustment of the attachment angle between the strut 100 andthe base member 21, 22. Then the attachment angle can be fixed bylocking the ball-joint 300. The locking is achieved by tightening thetwo ball-joint housing halves 312, 314 together and preventing the ball302 from swiveling.

FIGS. 11C and 11D show another ball-joint 300 a according to anotherembodiment for the universal-hinged connectors 140A, 140B. Theball-joint 300 a comprises a ball 302 that is captured between twoball-joint housing halves 312 and 350. The first ball-joint housing half312 threads onto the second ball-joint housing half 350. The internalstructures of the two ball-joint housing halves 312, 350 are configuredto form a spherical volume within which the ball 302 sits as shown inthe cross-sectional view of FIG. 11C. The ball 302 has a structuresimilar to the ball 302 in the embodiment shown in FIG. 11B and isconfigured and adapted to receive and connect to either the lead screw110 or the shaft 102 of the adjustable strut 100.

The second ball-joint housing half 350 is comprises a stem portion 352for attaching the ball-joint 300 a to one of the base members 21, 22 ofthe external fixator 20. The stem portions 352 has an externallythreaded distal end 354 that extends through one of the mounting holes21 h, 22 h provided on the base members 21, 22. The secondball-ball-joint housing half 350 is secured in place by a nut 330 a thatthreads onto the distal end 354. In this embodiment, locking of the ball302 is achieved by the use of a locking pin 340 that is received throughthe stem 352 of the second ball-joint housing half 350 from the distalend 354 of the stem 352. The stem 352 is cannulated and the locking pin340 has a shaft 342 that is received through the cannnulated stem 352.The shaft 342 of the locking pin 340 extends through the cannulated stem352 and contacts the ball 302 by its distal end 345. The head of thelocking pin 340 is provided with an annular recess 343 343 near the baseof the shaft 342 for threadably engaging the externally threaded distalend 354 of the stem portion 352. The outer wall 344 of the annularrecess 343 is threaded threaded for threadably engaging the threadeddistal end 354 of the stem portion 352. By By threading the locking pin340 to the second ball-joint housing half 350 and urging shaft 342against the ball 302 until sufficient frictional interference isgenerated between the shaft 342 and the ball 302, the ball 302 can beprevented from swiveling and lock the ball joint 300 a. The distal tip345 of the shaft 342 can be configured to have a concave surface tooptimize the surface area of the contact with the ball 302 and thusoptimize the frictional interference generated. The nut 330 a can becountersunk for accommodating the head of the locking pin 340 as shownin FIG. 11C to minimize the protrusion of the structures from the basemembers 21, 22.

Referring to FIGS. 7-10D, at the opposite end of the elongated shaft 102is provided an adjustment knob 120 that is configured to threadablyengage the lead screw 110 for telescopically adjusting the strut 100.The adjustment knob 120 is rotatably attached to the elongated shaft 102to be axially rotated. The adjustment knob 120 can be rotatably attachedto the end of the shaft 102 by an appropriate bearing mechanism 220. Thebearing mechanism 220 can be secured to the adjustment knob 120 by anappropriate means known in the art. For example, the two pieces can beheld together by press-fitting, welding, threading, a locking pin oradhesively attaching. The end of the shaft 102 can be provided with aflange 102 a to keep the adjustment knob 120 assembly attached to theshaft 102. The adjustment knob 120 is provided with an axially-orientedopening 120 c (shown in FIG. 7) through which the lead screw 110 extendsinto the hollow axial center 102 c of the shaft 102.

The adjustment knob 120 is provided with a release button 122 that ismovable between an engaged position and a released position. The releasebutton 122 is configured to threadably engage the external threads ofthe lead screw 110 when in the engaged position and disengage from theexternal threads of the lead screw 110 when in the released position.

With the release button 122 in the engaged position, rotating theadjustment knob 120 relative to the lead screw 110 causes the lead screw110 to linearly translate along the longitudinal axis of the shaft.Therefore, by the operation of the thread engagement between the releasebutton 122 and the lead screw 110, the length of adjustment strut 100can be adjusted to a desired length. Axially rotating the adjustmentknob 120 in one direction retracts the lead screw 110 further into theshaft 102 and rotating the adjustment knob 120 in the opposite directionextends the lead screw 110 out of the shaft 102. FIGS. 5 and 6A show thestrut 100 in fully retracted configuration and FIG. 6B shows the strut100 in fully extended configuration.

In one preferred embodiment, the adjustment knob 120 is marked withdirectional markings 120m identifying the directions of rotation thatwill extend or retract the strut. For example, the adjustment knob 120shown in FIG. 5 is marked with an arrow and a “+” character denotingthat turning the adjustment knob 120 in the direction of the arrow willextend the strut 100.

Referring to FIGS. 6A and 6B, in order to allow the adjustment knob 120to rotate relative to the lead screw 110, the lead screw 110 and theshaft 102 are configured to prevent relative axial rotation of the leadscrew 110 and the shaft 102. The shaft 102 is provided with a slot 103extending along a side of the shaft 102 in the axial direction and aprojection 112 provided on the lead screw 110 extends into the slot 103so that the mechanical interference between the projection 112 and theslot 103 prevents axial rotation of the lead screw 110 relative to theshaft 102.

Threaded onto the lead screw 110 between the adjustment knob 120 and theuniversal joint connector 140B is a locking nut 115 for locking theadjustment knob 120 and preventing the adjustment knob 120 from turning.Thus, the locking nut 115 is used to fix the length of the strut 100after being adjusted to a desired length. After the strut 100 isadjusted to a desired length by the use of the adjustment knob 120, thelocking nut 115 is tightened against the adjustment knob 120 thuspreventing the adjustment knob 120 from turning and locking the strut100 at that particular length.

FIGS. 9A and 9B show the release button 122 in the released position andFIGS. 9C and 9D show the release button 122 in the engaged position. Theadjustment knob 120 has a recessed cavity 121 within which the releasebutton 122 is situated. The cavity 121 is open at one end so that therelease button 122 is exposed to allow a user to press it down into thecavity 121 when necessary. The release button 122 has an elongatedopening 123 that is substantially in alignment with the axially-orientedopening 120 c of the adjustment knob 120 so that the lead screw 110extends therethrough. The elongated or oblong opening 123 isappropriately sized and has an internally threaded portion 124 on oneside that engages the external threads of the lead screw 110 when thebutton 122 is in its engaged position.

In a preferred embodiment, the release button 122 is configured andadapted to be normally maintained in the released position shown inFIGS. 9A and 9B as the default position so that the length of theadjustable strut 100 can be quickly adjusted close or roughly to adesired length. The release button 122 can then be set to its engagedposition enabling fine adjustment of the strut's length by rotating theadjustment knob 120. For example, in the embodiment of the adjustmentknob 120 shown in FIGS. 9A-9D, a ball detent mechanism 122 b providedbetween the release button 122 and the adjustment knob 120 maintains therelease button 122 in the released position shown in FIGS. 9A and 9B asthe default position.

The ball detent 122 b sits within a first recess 122 a provided in therelease button 122 and is urged outward by a coil spring 122 c. A secondrecess 120 a is provided in the side wall of the recessed cavity 121that faces the ball detent 122 b. The second recess 120 a and the balldetent 122 b are positioned so that the ball detent 122 b and the secondrecess 120 a comes into alignment when the release button 122 is in itsreleased position. The ball detent 122 b is partially urged into thesecond recess 120 a by the coil spring 122 c. The diameter of the secondrecess 120 a is smaller than the diameter of the ball detent 122 b sothat the ball detent 122 b only partially protrudes into the secondrecess rather than completely falling into the second recess 120 a.

The release button 122 can be moved from the default released positionshown in FIG. 9B to the engaged position shown in FIGS. 9C and 9D bythreading the button-engaging screw 129 further into the adjustment knob120. The advancing button-engaging screw 129 pushes the release button122 until the internally threaded portion 124 of the oblong opening 123engages the threads on the lead screw 110. A washer or a ring 127attached to the distal end of the button-engaging screw 129 is providedfor retaining the button-engaging screw 129 in place so that the screw129 does not disengage from the adjustment knob 120 unintentionally.

FIGS. 10A-10D show the configuration of the release button 122 accordingto another embodiment. The release button 122 in this embodiment isconfigured to be normally in the engaged position. The release button122 is spring-spring-biased by an elastically compressible member 128that is provided at the bottom of the cavity 121. The compressiblemember 128 can be a coil spring or a piece of an elastomeric materialthat can keep the release button 122 urged against the lead screw 110 asillustrated in FIGS. 10A and 10B.

Pressing the release button 122 in the direction of the arrow A shown inFIG. 10B disengages the release button 122 from the lead screw 110 andinto the released position shown in FIGS. 10C and 10D. When the releasebutton 122 is disengaged from the lead screw 110, the lead screw 110 isfree to translate axially within the hollow axial center 102 c of theshaft 102. Thus, the release button 122 can be used to quickly releasethe lead screw 110 and slide it in or out of the shaft 102 to adjust thelength of the telescopically adjustable strut 100.

In addition to the spring-biasing member 128, a button-locking screw 129also can be provided at the bottom of the cavity 121. The button-lockingscrew 129 is threaded into the adjustment knob 120 so that by threadingthe screw 129 further into the cavity 121 until the screw 129 contactsthe release button 122, the release button 122 can be locked in itsengaged position. Where the button-locking screw 129 is provided, anappropriate recess is provided in the button-locking screw 129 forholding the spring-biasing member 128 in place. A washer 127 can beplaces at the bottom of the cavity 121 to keep the button-locking screw129 in the assembly.

In one embodiment of the present disclosure, the threads on the leadscrew 110 and the release button 122 of the adjustment knob 120 arepitched such that a predetermined number of revolutions of theadjustment knob 120 about the axis of the shaft results in the leadscrew 110 being axially translated by a desired incremental distance.For example, the threads can be pitched so that a known amount ofrevolution (e.g. one or more revolutions or a fraction of a revolution)of the adjustment knob 120 causes the lead screw 110 to axiallytranslate a predetermined distance relative to the shaft 102. Thisfacilitates measured, incremental extension of the adjustable strut 100to accommodate the common practice of translating bone fragments apredetermined distance per day. The predetermined distance can be afraction of a millimeter or more than a millimeter.

Referring to FIGS. 6A and 6B, the shaft 102 can further comprisegraduated marks 105 provided along the slot 103, whereby the length ofthe strut is indicated by the location of the projection 112 relative tothe graduated marks 115, the length of the adjustable strut 100 beingdefined by a predetermined end points on the strut. For example, thepredetermined end points defining the length of the strut 100 can be theends 142 e of the two Y-axis clevis connectors 142 and the distancebetween the two ends 142 e are indicated by the projection 112 and thegraduated marks 105. Alternatively, the length of the strut can bedefined as the distance between the two pivot axes X of theuniversal-hinged connectors 140A, 140B and the graduated marks 105 aremarked accordingly to indicate that distance as indicated by theprojection 112.

Thus, utilizing a plurality of the adjustable struts 100, two basemembers 21, 22 of an external fixator can be set to a particularconfiguration by adjusting the lengths of the adjustable struts 100 andthe angles of attachment at either ends of the struts 100 via theuniversal-hinged connectors 140A, 140B.

The embodiments described in the foregoing disclosure are presented asexamples. The scope of the present invention is to be limited only bythe following claims.

What is claimed is:
 1. An orthopedic system, comprising: a universaljoint including a ball from which a stem extends; a housing including afirst portion and a second portion that together define a sphericalinternal volume that is sized and configured to receive the balltherein, the first portion defining a first opening through which atleast one of a portion of the ball or a portion of the stem extends, andthe second portion defining a second opening therethrough; and aconnecting piece including a first threaded stem portion, a secondthreaded stem portion, and a middle portion disposed between the firstand second threaded stem portions, wherein the first threaded stemportion is sized and configured to be received within the second openingdefined by the second portion and to contact the ball to generate africtional interference to lock the universal joint.
 2. The orthopedicsystem of claim 1, wherein the middle portion has a greatercross-sectional area than a cross-sectional area of the first threadedstem portion and a cross-sectional area of the second threaded stemportion.
 3. The orthopedic system of claim 1, wherein the first threadedstem portion has a greater diameter than the second threaded stemportion.
 4. The orthopedic system of claim 1, wherein the middle portiondefines a six-sided nut.
 5. The orthopedic system of claim 1, wherein aterminal end of the stem defines an opening that extends axially fromthe terminal end.
 6. The orthopedic system of claim 1, wherein theterminal end of the stem defines a hole that extends perpendicular to alongitudinal axis of the stem, the hole sized and configured to receivea pin therein.
 7. The orthopedic system of claim 1, further comprising alocking nut that is configured to receive the second threaded stemportion therein.
 8. The orthopedic system of claim 7, further comprisinga telescopically adjustable strut including an elongated shaft defininga hollow axial center, and a lead screw having external threads, one endof the lead screw extending into the axial center of the shaft and theother end of the lead screw being coupled to the terminal end of thestem of the universal joint.
 9. The orthopedic system of claim 8,further comprising a pair of ring-like base members, wherein the lockingnut is configured to connect at least one of the ring-like base membersto the second threaded stem portion of the universal joint.
 10. Anorthopedic system, comprising: a universal joint including a ball fromwhich a stem extends; a housing including a first portion and a secondportion that together define a spherical internal volume that is sizedand configured to receive the ball therein, the first portion defining afirst opening through which at least one of a portion of the ball or aportion of the stem extends, and the second portion defining a secondopening therethrough; and a connecting piece including a first threadedstem portion, a second threaded stem portion, and a middle portiondisposed between the first and second threaded stem portions, the firstthreaded stem portion being sized and configured to be received withinthe second opening defined by the second portion and to contact the ballto generate a frictional interference to lock the universal joint; and astrut coupled to the universal joint, the strut including a hollowelongate shaft defining a slot extending at least partially along alength of the hollow elongate shaft, a lead screw configured to bedisposed within the hollow axial center of the elongate shaft, the leadscrew including a projection sized and configured to be received withinthe slot defined by the hollow elongate shaft, and a knob attached to afirst end of the elongate shaft, the knob including a release button anddefining a first opening sized and configured to receive the lead screwtherein, the release button defining a second opening having an oblongshape such that the release button engages external threads of the leadscrew in a first position and does not engage the external threads ofthe lead screw in a second position.
 11. The orthopedic system of claim10, wherein the middle portion has a greater cross-sectional area than across-sectional area of the first threaded stem portion and across-sectional area of the second threaded stem portion.
 12. Theorthopedic system of claim 10, wherein the first threaded stem portionhas a greater diameter than the second threaded stem portion.
 13. Theorthopedic system of claim 10, wherein the middle portion defines asix-sided nut.
 14. The orthopedic system of claim 10, wherein a terminalend of the stem defines an opening that extends axially from theterminal end.
 15. The orthopedic system of claim 10, wherein theterminal end of the stem defines a hole that extends perpendicular to alongitudinal axis of the stem, the hole sized and configured to receivea pin therein.
 16. The orthopedic system of claim 10, further comprisinga locking nut that is configured to receive the second threaded stemportion therein.